File
Zeb A.1, Bahadur S.2, Ilyas S.M.1
1Paraplegic Center, Physical Therapy, Peshawar, Pakistan, 2Rehman Medical College, Research, Peshawar, Pakistan
Background: The medical care and management of spinal cord injuries(SCI) has significantly advanced, resulting in recovery of individuals living with SCI, however neurological recovery does not always translate into functional recovery.(1)Parallel to these advancements in understanding the underlying biological mechanisms altered by SCI, physical therapy plays a crucial role in recovery of functional abilities.
Purpose: To determine the outcome of gross mobility after physical therapy interventions based on motor relearning program for functional recovery of patients with a spinal cord injury.
Methods: It was a Sequential Multiple Assignment Randomized Trial (SMART). Motor relearning program (MRP)(2)was applied 3 days per week. This study was conducted in persons with post traumatic spinal cord injuries, admitted to the Paraplegic Center Hayatabad during 2015-16. Both pre and post intervention evaluation was done by using Spinal Cord injury Independence Measure (SCIM)(3)scale. The total score of the scale related to gross mobility is 40. Using census/consecutive sampling technique, 62patients with paraplegia were included in the study whereas patients with tetraplegia were excluded. Data was analyzed in SPSS version 20, where mean score of pre and post intervention (for each 6 visits, considering the first visit as base line) was compared to see the improvement. One samplet test was used and p value 0.05 was considered as significant.
Results: Total 62 patients participated in the study out of whom 17(27.4%) were female and 45(72.6%) were male. There was a gradual increase in the improvement of gross mobility in patients with spinal cord injuries as a result of physical therapy interventions based on motor relearning program (MRP). The mean score of gross mobility at first visit was 3.7± 6.39 (CI; 2.1-5.3) followed by 10.5 ± 11.1 (CI;7.7- 13.3) in second visit, 13.5± 10.4 (CI; 10.9 16.2) in third visit, 15.6± 10.1(CI; 13.0-18.25) in fourth, 16.73± 9.1 (CI; 14.4 -19.0) in fifth and18.8± 9.3(CI; 16.4 -21.1) in sixth visit respectively. The p value for consecutive mean difference was highly significant (P 0.001).
Conclusion(s): Physical Therapy based on motor relearning program (MRP)is an effective tool for improvement in gross mobility of patients with spinal cord injuries at paraplegic center, Hayatabad. Medical and nursing interventions and other individual and environmental factors may provide a synergetic effect in functional recovery, which needs to be investigated further.
Implications: This study provides an evidence for health policy makers and medical professionals to better integrate physical therapy/ rehabilitation services (especially rehabilitation of spinal card injury) in health care system in Pakistan.
Funding acknowledgements: The study was funded by Paraplegic center Hayatabad, Pakistan and technically supported by the International Committee of Red Cross.
Topic: Neurology: spinal cord injury
Ethics approval: This study was approved by the ethics Committee of Paraplegic center Hayatabad, Pakistan.
All authors, affiliations and abstracts have been published as submitted.
